This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This research is studying induced hypothermia in newborns after 6 hours of age to reduce death and improve outcomes of infants with Hypoxic-Ischemic Encephalopathy [HIE]. HIE results from decreased blood flow and oxygen to all organs in the body including the brain (caused by infections or placenta/umbilical cord problems). The risk of death or handicaps in infants who survive HIE is 50%. Presently, infants diagnosed with HIE less than six hours of age are cooled to decrease their body temperature 91.4-93.2 degrees F for 72 hours. Previous animal and human research has shown that induced hypothermia appears to be the most promising treatment to protect babies brains. Safety information in newborn babies cooled in their first 72 hours have shown no bad effects. Information suggests brain injury occurs over days to weeks following HIE. It is unknown if induced hypothermia is beneficial if started at a later age [after 6 hours]. Some infants with HIE have not yet arrived at a hospital where induced hypothermia is offered, or may not show signs of HIE until after they are 6 hours old. It is also unknown if a longer period of induced hypothermia [more than 72 hours] may be beneficial. The purpose of this study is to evaluate whether induced hypothermia begun between 6 and 24 hours of age and continuing 96 hours in infants who were born within 4 weeks of their due date and who show signs of HIE will reduce death and improve outcomes at 18 months.